Televised Direct to Consumer Pharmaceutical Advertising and Patient Outcomes

描述(申请人提供)：制药业每年花费数十亿美元在处方药的直接面向消费者的广告(DTCA)上。由于向公众传递健康信息的挑战和可能产生意想不到的后果，DTCA的优点一直受到相当大的争论。尽管有几项研究考察了DTCA对消费者行为和健康结果的影响，但大多数研究使用的是总支出，而不是更精细的广告暴露衡量标准，而且大多数研究量化了DTCA对单一药物或治疗类别的影响。这一点很重要，因为通常宣传的药物治疗的患者在患者群体、严重性、慢性病和症状方面存在显著差异，这些差异可能会影响DTCA的效果。此外，很少有调查研究患者或地区卫生系统的特征如何缓和直接面向消费者的广告的影响，但经济学和行为理论都表明，这些因素可能对其效果产生重要影响。广告的内容也有重要的变化，来自其他健康传播领域的研究表明，这些内容影响消费者对健康信息的反应，但很少有分析评估DTCA的定性和执行特征如何影响其效果。我们提出了一系列相互关联的目标，这些目标利用了医疗保健利用数据的独特组合，这些数据来自现有最大的健康计划保险索赔集合之一，以及来自尼尔森媒体研究公司的电视广告曝光度的衡量标准。我们将使用区域资源文件和IMS Health中的数据来补充此信息，以获取有关广告发生的上下文的信息。我们还将开发和应用一套代码来捕获关键的定性和执行性广告特征。这些数据的结合将使我们能够检查DTCA对医疗保健利用和跨治疗类别药物销售的影响，并探索个体特征、背景影响和广告特征对DTCA与利用和销售之间的关系的交互作用。凭借在广告和健康行为以及药物流行病学和药品政策研究方面的专业知识，我们的团队非常有资格执行拟议的研究。我们将使用先进的计量经济技术，我们的分析将为政策制定者和其他利益相关者提供重要信息，以寻求最佳地平衡直接面向消费者的广告的复杂风险和好处。

DESCRIPTION (provided by applicant): The pharmaceutical industry spends billions of dollars each year on direct-to-consumer advertising (DTCA) of prescription drugs. Because of the challenge of conveying health information to the public and the potential for unintended consequences, the merits of DTCA have been subject to considerable debate. Although several studies have examined the effect of DTCA on consumers' behavior and health outcomes, most have used aggregate spending, rather than more refined measures of ad exposure, and most have quantified the impact of DTCA regarding a single drug or therapeutic class. This is important because there are significant differences in the patient population, severity, chronicity, and symptomatology of conditions treated by commonly advertised drugs, and these differences may influence the effect of DTCA. In addition, few investigations have examined how patient or regional health system characteristics moderate the impact of direct-to-consumer advertising, yet both economic and behavioral theory suggest that such factors may have an important influence on its effects. There is also important variation in the content of ads, and work from other areas of health communication suggest that this content influences how consumers respond to health information, yet few analyses have assessed how qualitative and executional characteristics of DTCA may influence its effects. We propose a series of interrelated aims that capitalize on a unique combination of health care utilization data, derived from one of the largest collections of health plan insurance claims available, with measures of exposure to television ads derived from Nielson Media Research. We will supplement this information with data from the Area Resource Files and IMS Health to derive information regarding the context in which the advertising takes place. We will also develop and apply a set of codes capturing key qualitative and executional ad characteristics. The combination of these data will allow us to examine the effects of DTCA on health care utilization and pharmaceutical sales across therapeutic classes, and to explore the interaction of individual characteristics, contextual influences, and ad characteristics on the relationship between DTCA and utilization and sales. With expertise in the study of advertising and health behavior as well as pharmacoepidemiology and pharmaceutical policy, our team is highly qualified to perform the proposed research. We will use advanced econometric techniques and our analyses will yield important information for policymakers and other stakeholders seeking to optimally balance the complex risks and benefits of direct-to-consumer advertising.